Healthcare leaders unite to protect Eastern Sierra access to care
Regional hospitals, tribal health, county leaders, legislative offices
come together to discuss funding pressures, next steps for rural care

Leaders from across the Eastern Sierra gathered at Northern Inyo Healthcare District on April 23 to discuss the challenges facing rural healthcare and how to protect access to care for communities throughout Inyo and Mono counties and neighboring areas.

The working session brought together representatives from Northern Inyo Healthcare District, Toiyabe Indian Health Project, Southern Inyo Healthcare District, Inyo County Health and Human Services, statewide hospital organizations, and the legislative offices of U.S. Sen. Adam Schiff, U.S. Rep. Kevin Kiley, State Sen. Marie Alvarado-Gil, and State Assemblyman David Tangipa. Mammoth Hospital was invited to attend, but had a Board of Directors meeting scheduled at the same time.

Participants spoke about the impact of the “One Big Beautiful Bill” (HR1) funding cuts, ongoing rising costs, workforce shortages, changes in Medicaid policy, and opportunities through the Rural Health Transformation Program. The meeting also included a tour of NIHD facilities, including the aging modular units that currently house primary care clinic services. Leaders said the units are a reminder of how limited clinic space is already affecting access to care locally.

Christian Wallis, CEO of Northern Inyo Healthcare District, credited the California Special Districts Association with helping bring partners together and said regional cooperation is essential.

“We all realized that we are codependent on each other,” Wallis said. “If one hospital struggles, it affects the entire Eastern Sierra. We all have to survive together, or we’re all going to fail.”

Healthcare leaders described a shared reality across the Eastern Sierra. Communities are far from major medical centers. The region has a higher share of older residents. Many patients rely on Medicare or Medi-Cal. Travel for specialty care often takes several hours.

At Southern Inyo Healthcare District, CEO Dr. Kevin Flanigan described the challenges facing frontier hospitals that serve both small local populations and large numbers of visitors each year.

“We are a critical part of both the health and safety in Southern Inyo County,” Flanigan said. “We want to be a part of tomorrow’s system, but we need investment now to participate in that system.”

Flanigan said Southern Inyo Healthcare District made progress stabilizing operations after facing a fiscal crisis with more than $3 million in unpaid vendor invoices. However, he said the District still expects a deficit later this year without additional support. He also noted that delayed supplemental payments and uncertainty about future reimbursements continue to create challenges for rural hospitals.

Northern Inyo Healthcare District leaders shared similar concerns. Although recent federal employee retention credits temporarily strengthened cash reserves, the hospital continues to face a gap between the cost of care and what reimbursement covers. Like many rural hospitals in California, NIHD depends on supplemental funding programs to help close that gap.

Wallis said those supplemental payments remain essential. “We’ve been riding this line of supplemental funds to make us whole for at least a decade,” he said. “We need to reduce that gap and build a sustainable future.”

Toiyabe Indian Health Project CEO Earl Lent described the funding structure that supports the tribal health system, which serves seven federally recognized tribes across the region.

“The clinic is financially strong and healthy,” Lent said. “But we are still very dependent on what happens at the federal level. Changes to Medicaid and pharmacy reimbursement models will affect us, and we want to support our local hospitals because they support our communities.”

He said collaboration between tribal providers and the region’s hospitals helps improve coordination and patient outcomes.

Anna Scott, Director of Inyo County Health and Human Services, said possible changes to Medicaid eligibility rules could affect both patients and local providers.

“We’re looking at upwards of 40 percent of our population covered by Medicare and up to 30 percent covered by Medi-Cal,” Scott said. “When people lose access to coverage and hospitals still have to provide care, the strain on our healthcare system is very real.”

A central focus of the meeting was the Rural Health Transformation Program, a $50 billion federal effort created through HR 1, also known as the “One Big Beautiful Bill.” The program supports rural hospitals and providers as they work together more closely and adopt new care models to better serve patients in rural areas.

Regional leaders said one important opportunity under the program is installing a shared electronic health record (EMR) system. A shared system would help hospitals and clinics communicate more easily and coordinate care for patients who travel between communities.

“If we get an EMR that we can all be on together, it’s a game changer,” Wallis said. “It improves patient transfers, care coordination, and access across the region.”

Participants also discussed expanding telehealth services to create access to specialty services, supporting maternity care through retention and recruitment, and strengthening local workforce development.

Representatives from state and federal offices said they understand the challenges facing rural providers and plan to continue working with local leaders as policy decisions move forward.

Participants also discussed how changes to Medicaid eligibility, supplemental funding programs and rural hospital financing could affect healthcare access across the Eastern Sierra. Legislative staff said rural healthcare remains a bipartisan priority and that they will continue sharing local concerns with policymakers.

Healthcare leaders agreed the meeting marked an important step toward stronger regional coordination. The group hopes to establish a regular meeting schedule to continue working together on shared priorities. The discussion also comes ahead of the May 4 special joint meeting between the Northern Inyo Healthcare District and Mammoth Hospital boards.

Wallis said cooperation across hospitals, tribal health systems and county services is key to keeping care available close to home. “We’re stronger when we work together,” he said. “That’s why bringing everyone to the table matters.”

 

 

 

 

About Northern Inyo Healthcare District: Founded in 1946, Northern Inyo Healthcare District features a 25-bed critical access hospital, a 24-hour emergency department, a primary care rural health clinic, a diagnostic imaging center, and a rehabilitation service for physical, occupational, and speech-language therapy. We also offer clinics specializing in orthopedics, cardiology, urology, women’s health, pediatrics and allergies, general surgery, colorectal surgery, and breast cancer surgery. Continually striving to improve the health outcomes for those who rely on us for care, NIHD aims to improve our communities, one life at a time. One team, one goal, your health.